Certain types and severities of bone fractures require orthopedic surgery to properly align the fracture and to implant an artificial structure across the fracture to maintain the proper alignment and reinforce the fractured bone as the fracture heals. An example of a fracture that often demands the implantation of an artificial structure across the fracture is a fracture at the distal radius, which is one of the most common sites of bone fracture and is the most common fracture site in the upper extremity, accounting for approximately 10% of all fractures in adults. A distal radial fracture often occurs as a compression injury that is sustained while the patient experiences axial loading of the bone as a result of a fall. This type of fracture is particularly common in elderly patients due to osteoporosis and in younger, physically active patients.
In 2004, there were over 1.5 million distal radial fractures, and this number is expected to increase steeply as the population ages. However, despite this frequency, the methods available to repair the distal radius are limited and prone to a variety of complications that limit the clinical outcome following definitive treatment. For example, open reduction of the distal radius enables the surgeon to most confidently realign the distal radius bone fragments and restore stability to the joint. This method is required in approximately 25% of patients (˜375,000/year). Unfortunately, current practice requires the surgeon to disrupt the soft tissues over a 10 cm distance adjacent to the joint to expose the bone for placement of hardware to stabilize the fracture, such as a dorsal or volar locking plate. Thus, improved bone stability is achieved by sacrificing the integrity of an extensive tendon, ligament and neuromuscular network that is critical for proper wrist function. Also, plating techniques external to the bone can become a source of irritation to the soft tissue, including tendons and peripheral nerves. Such soft tissue irritation necessitates revision surgeries in over 30% of patients to remove the offending plates. This results in additional cost, disability and surgical risk to the patient. Furthermore, since plates are load-shielding as opposed to load-sharing, plates do not promote the bone remodeling that is necessary for better long-term strength of the bone tissue. Similar issues exist with respect to the treatment of other types of fractures (e.g., fractures in long bones, such as, for example, the proximal ulna and radius at the elbow, the distal humerus at the elbow, the proximal humerus at the shoulder, the proximal femur at the hip, the distal femur and proximal tibia at the knee, the distal tibia and other ankle and foot bones, the clavicle, and the spine, etc.)
There is a need in the art for devices and methods that offer improved outcomes for the treatment of bone fractures, resulting in better aligned and stronger healed fractures, reducing the likelihood of a revision being necessary, and reducing the damage to soft tissue adjacent the fracture. There is also a need in the art for devices and methods that offer a reduction in the surgical time required for the treatment of bone fractures.